As If Traveling With Diabetes Wasn’t Hard Enough


Traveling is always a pain when you have diabetes. Making sure you have everything you need can take up an extra bag – insulin, test strips, glucometer, extra needles etc. Like most people with diabetes, I take all my supplies with me in a carry-on.  It’s uncomfortable and means there’s a fair chance of being harassed by airport security.

I once spent a week in Turkey without a glucometer.  I’d forgotten to pack mine. My hotel didn’t have one and neither did the pharmacy in the town nearby.  Since I was in the middle of nowhere in Turkey and had no good way to communicate my needs, I just gave up. I knew it was irresponsible to have no idea how high my blood sugar was.  I guessed when I bolused and I was lucky that everything turned out okay. (My following A1c was high.)

Since then, I always stress about traveling and the longer the flight the worse it is. I have always found it difficult to manage my blood sugar levels on trips (even when I have a glucometer). The long periods of driving and flying (with very little movement) together with the unfamiliar food usually causes my blood sugar levels to rise. On short flights I don’t eat at all and on very long flights (like the 10-12 hour Tel Aviv – New York flight) I eat very little. I’ve also taken to completely cutting out carbs when in unfamiliar places.

As if all this wasn’t enough I woke up this morning and went to look at the latest news and  found a Reuters’ report saying a new study claims that changes in cabin pressure during flights may cause insulin pumps to deliver too much or too little insulin.

The study was conducted after Australian researchers learned of a 10-year-old girl with type 1 diabetes whose blood sugar got too low an hour after take-off.  After looking in to it the researchers found other cases of pumpers who had reported the same problem during flights.

To see what was going on, the researchers put ten Medtronic and Animas insulin pumps on a commercial flight.   They found that during takeoff (when air pressure was decreasing), the pumps delivered about 1 to 1.4 extra units of insulin, on average (OMG!! – my basal rate is 0.45 u/h). And during descent, when pressure was increasing, some insulin was sucked back into the pumps — causing them to give out too little insulin, by less than 1 unit.

Although the companies, Medtronic and Animas, did not have much to say on the matter, the researchers set out a list of recommendations for pumpers to follow during flights.

Their recommendations include:

  • Insulin cartridges should only contain 1.5 milliliters of insulin.
  • Diabetics should disconnect the pump before takeoff, remove air bubbles and reconnect at cruising altitude.
  • Disconnect again and prime the line with 2 insulin units after landing before reconnecting for good.
  • The pump should be disconnected during flight emergencies when there’s a big drop in cabin pressure.

So now that I’m pumping I have a whole new set of things to worry about when I travel.

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11 years ago

A technical clarification…air pressure does NOT decrease at take off. It is lower at higher altitudes, when the plane is cruising.

Dr. Margaret A. Morris
11 years ago

Hah! I knew it! I’ve always suspected changes in air pressure did something weird with insulin, because my blood sugar often behaves unpredictably on flights, and used to be really weird when we drove from the Bay up several thousand feet to Lake Tahoe, and likewise while going back down. Thanks for the very useful information! (I’ll be boarding a flight home to San Diego in just a few hours…)

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